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ICD-10 Guide
ICD-10 CodesH02.152

H02.152

Billable

Paralytic ectropion of right lower eyelid

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 H02.152 is a billable code used to indicate a diagnosis of paralytic ectropion of right lower eyelid.

Key Diagnostic Point:

Paralytic ectropion of the right lower eyelid is characterized by the outward turning of the eyelid margin due to paralysis of the facial nerve, which innervates the orbicularis oculi muscle responsible for eyelid closure. Clinically, patients may present with exposure of the conjunctiva and cornea, leading to symptoms such as dryness, irritation, and potential corneal damage. The anatomy involved includes the eyelid structure, particularly the lower eyelid, and the surrounding periocular tissues. Disease progression can vary; if left untreated, it may lead to chronic irritation, exposure keratitis, and even vision impairment. Diagnostic considerations include a thorough clinical examination, assessment of facial nerve function, and possibly imaging studies to rule out underlying causes such as tumors or trauma. Treatment typically involves surgical intervention to correct the eyelid position and restore function, alongside supportive care for any corneal exposure.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of facial nerve function and eyelid anatomy.
  • Treatment complexity: May involve surgical correction and management of complications.
  • Documentation requirements: Detailed clinical notes and evidence of nerve involvement are necessary.
  • Coding specificity: Requires precise coding to differentiate from other types of ectropion.

Audit Risk Factors

  • Common coding errors: Misidentification of the eyelid affected or confusion with other eyelid disorders.
  • Documentation gaps: Incomplete records regarding the extent of paralysis or treatment history.
  • Billing challenges: Potential denials if the medical necessity is not clearly established.

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Plastic Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Paralytic ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision loss if not addressed. Understanding the epidemiology of facial nerve disorders can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to eyelid disorders emphasize timely diagnosis and intervention, which can improve patient outcomes and reduce healthcare utilization.

ICD-9 vs ICD-10

Paralytic ectropion can significantly affect a patient's quality of life, leading to discomfort and potential vision loss if not addressed. Understanding the epidemiology of facial nerve disorders can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to eyelid disorders emphasize timely diagnosis and intervention, which can improve patient outcomes and reduce healthcare utilization.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of surgical intervention and any associated procedures. Common denials may arise from insufficient documentation of the condition's impact on the patient's daily life or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical notes, imaging results, and treatment plans are included in the patient's medical record to support the claim.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by H02.152?

H02.152 specifically covers paralytic ectropion of the right lower eyelid, which may arise from conditions such as Bell's palsy, stroke, or trauma affecting the facial nerve.

When should H02.152 be used instead of related codes?

H02.152 should be used when the diagnosis specifically involves the right lower eyelid and is due to paralysis. It is important to differentiate it from other types of ectropion, such as involutional or cicatricial ectropion.

What documentation supports H02.152?

Documentation should include a detailed history of the patient's facial nerve function, clinical examination findings, and any imaging studies performed. Notes should clearly indicate the diagnosis of paralytic ectropion and the affected eyelid.